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MORRIS - Proposed recommendations to change the rules for licensed family child care providers could increase the cost of child care and make it more difficult to provide child care for infants locally, representatives of the Concerned Licensed Child Care Providers of Stevens County told parents and local officials at an informational meeting on Monday.

In response to a sharp increase in the number of infants who have died while in a licensed family child care home, officials with the Minnesota Department of Human Services are considering a series of recommendations to reduce the risk of sudden unexpected infant death (formerly called SIDS - sudden infant death syndrome).

The recommendations were developed by the Child Mortality Review Panel, a group responsible for examining all child deaths in DHS licensed facilities. Local child care providers are concerned what the impacts of these recommendations could be.

Last May, the panel began to investigate an increase in the number of child deaths in licensed family child care homes between 2001 and 2012.

According to a report issued by the panel, between January 2001 and August 2012, 83 children died in licensed facilities in Minnesota; 96 percent of the deaths children who have died have been in family child care homes rather than child care centers.

Seventy-five percent of those deaths occurred when the infant was sleeping or in a sleep environment, and all of the deaths that occurred in family child care homes happened in homes licensed for ten or more children; however, 96 percent of the child care homes in the state are licensed at that level.

The report offers 34 recommendations for DHS to consider and decide which licensing changes, if any, they will recommend to the legislature, said Stevens County Human Services Director Joanie Murphy.

Stevens County has one licensed child care center, the Morris Area Child Care Center, and 37 licensed family providers. The child care centers are licensed by DHS, while family providers are licensed by the county based on rules developed by the state, Murphy said.

At Monday's meeting, family day care providers emphasized that nothing is more important than the life of a child, but questioned whether some of the recommendations would actually lower the risk of infant mortality or simply create hardships for parents and providers.

The recommendations from the report range from increasing the minimum age of child care "helpers" to 16 years old to requiring providers to pass a written exam to receive a child care license to increasing initial and ongoing training for providers.

Many of the recommendations also focus on policies for safe sleep - requiring babies to sleep on their backs, for example - and increasing penalties for providers who are found in violation of safe sleep practices.

One recommendation, for example, would require that a child care providers license be revoked if an infant is found in an unsafe sleep environment or sleep position.

"That's a pretty scary thing, to know that if I'm going to be taking an infant that I could have my licensed revoked," said provider Dorothy Sayre.

One of the most concerning recommendations was a suggestion to modify the ratios of children to providers that are allowed. Although provider Sherry Tiegs said it appeared this recommendation was off the table, local providers were concerned it could come back.

While having fewer children would impact income, Tiegs said she was also concerned it would result in parents having to take children to multiple providers to accommodate an infant or cut back on offering part-time care or care for families on assistance programs.

"I get phone calls, and I know these ladies do too, on a daily basis looking for infant care," said Tiegs. "We're full, full right now. There are a lot of babies right now."

"We certainly don't have an over-abundance of infant care," Murphy concurred. "If providers - whatever comes out of this - if they believe that it's too much for them in terms of responsibility and they opt to quite providing care altogether or not provide infant care, that's certainly going to negatively impact our overall capacity in Stevens County."

Although Murphy said she hasn't heard many specifics about which recommendations might move forward, one issue that has some up in state-level meetings with DHS is requirements for more training for providers, specifically about safe sleep.

At the meeting, provider Vicki Dalager said the recommendation to require 24 hours of training annually would triple the current training requirements and create a hardship for providers who may have to travel for training and a cost that would passed on to parents.

"All of the training in the world isn't going to prevent SIDS as long as we don't know what causes it, we can't prevent it," said Dalager. "We could have 100 hours of training and babies are still going to die of SIDS."

At the close of Monday's meeting, Tiegs urged attendees to contact their legislators with their thoughts on the proposed recommendations. Local providers will also be attending a stakeholder meeting with DHS in St. Cloud next week to share their concerns and, they hope, impact which recommendations go before the legislature.

"As you look at these recommendations ... as a parent, as an official, as a day care provider, take a hard look at them and see if you can pick the good things out of there ... and figure out what is not going to work, what is really going to cause a hardship," said Tiegs.